Are You Ready for ICD-10?

The time has come. ICD-10 is here. Your months and years of ICD-10 preparation will now be put to the test. It is time to stop anticipating ICD-10 and start tracking its impact on your revenue.

Across the country, hospital executives fear the effects of ICD-10 on their revenue, and for good reason. The Centers for Medicare and Medicaid Services (CMS) predicts that hospitals and health systems could see payments decline for up to two years after ICD-10 takes effect.

It doesn’t end there. CMS predicts that:

  • Denials could increase by 200%
  • Accounts receivables could rise to 40%
  • Claim error rates could grow 10%

But you don’t need to go it alone. Data analytics can shine a light on your ICD-10 efforts and help you approach it with confidence. Our advanced analytics enable you to measure, monitor, and benchmark the impact of ICD-10 so you can identify outliers, prevent denials, and protect your bottom line.

Follow these top five tips as you track your ICD-10 performance with data analytics:

Tip #1: Trend and benchmark CMI, unspecified code usage, and secondary diagnosis codes.

Let your data show you how your ICD-10 performance compares to your peers. Say 90% of your peers are coding for a particular secondary diagnosis code but you are not. Understand why that is and take steps to rectify the problem.

Tip #2: Reduce denials by identifying their trends and causes.

It’s a fact. Denials will increase after ICD-10 takes effect. But you can take control over them now, before they pose significant risk to your revenue. When you identify the trends and causes of documentation and coding denials, you can spot where your ICD-10 coding efforts may be going wrong and what you can do to help ensure your claims get paid.

Tip #3: Identify required specificity missing from physician documentation.

ICD-10 is all about specificity. Your physician documentation needs to be specific to make sure you are paid for the complexity of care you provide. Unlike some analytics solutions, our proprietary ICD-10 analysis can identify which documentation concepts are missing and causing a lower level of specificity.

Tip #4: Track coding and billing efficiency trends.

CMS predicts that your accounts receivables will rise. Let your data identify where any bottlenecks may exist in coding and billing. Discover and resolve these bottlenecks to reduce their impact on your revenue.

Tip #5: Mitigate compliance risk related to ICD-10.

Your compliance department must remain diligent after ICD-10 takes effect. ICD-10 will magnify the potential for documentation and coding compliance issues. Let our compliance risk rules engine scan your claims on a daily basis so you can identify potential ICD-10 audit targets and areas of risk.

For more information about how MedeAnalytics can help you measure, monitor, and benchmark the impact of ICD-10 on your revenue, visit www.medeanalytics.com/revenue-integrity or contact us at info@medeanalytics.com.

Be sure to visit us at AHIMA, booth #1443, September 26-30. To schedule a private demonstration, email Katie.Broussard@medeanalytics.com.

Posted in

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Leave a Comment





Get our take on industry trends

How to spark support for important analytics initiatives

How to spark support for important analytics initiatives

June 8, 2021

MedeAnalytics hosted a webinar with Fierce Healthcare to explore three industry experts’ perspectives on building analytics strategies and maximizing related…

Read on...
Pandemic devours hospital revenue; these ideas can help get it back

Pandemic devours hospital revenue; these ideas can help get it back

June 3, 2021

There’s no way around it. The coronavirus pandemic has created a perfect storm that, even as we progress through the…

Read on...
The Real Payback of Healthcare Analytics: Key Questions from Healthcare Leaders Around the Nation

The Real Payback of Healthcare Analytics: Key Questions from Healthcare Leaders Around the Nation

May 25, 2021

MedeAnalytics hosted a Fierce Healthcare webinar featuring key senior leaders from three preeminent healthcare organizations in the U.S: At the…

Read on...
The future of digital health part 4: Convergence of AI and analytics for healthcare payers

The future of digital health part 4: Convergence of AI and analytics for healthcare payers

May 12, 2021

This post is the fourth and final of our Digital Health series, featuring healthcare visionary and thought leader Andy Dé. In this series, Dé has been discussing how COVID-19 has triggered remarkable digital transformation and uncovers five long-term innovation implications that providers, healthcare leaders, and payers need to consider.

Read on...